Pamidronate - TheGIConnection

Class: Bisphosphonate

Generic Name: Pamidronate (peh-MI-droe-nate)

Trade Name: Aredia®

How is this drug used? Pamidronate is FDA approved for the treatment of hypercalcemia (high levels of calcium in the blood) in patients with cancer. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Pamidronate belongs to a class of drugs called bisphosphonates. Bone is constantly being remodeled, meaning that old bone is removed by cells called osteoclasts (referred to as resorption) and new bone is laid down by cells called osteoblasts. Sometimes, patients with cancer have excessive resorption, leading to high levels of calcium in the blood. Pamidronate produces its anti-cancer effects by inhibiting excessive bone resorption.

How is pamidronate given (administered)? Pamidronate is administered into a vein (intravenous).

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with pamidronate. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems, such as the kidneys or liver. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

Prior to each dose of pamidronate, patients may have their kidney function checked. Patients will also have their calcium levels and other electrolyte levels in their blood checked during treatment with pamidronate. Patients will be monitored for signs of hypercalcemia, such as muscle twitching, frequent urination, loss of appetite, nausea or vomiting, constipation, weakness or fatigue, muscle, confusion, and coma.

What are the common (occur in 30% or more of patients) side effects of treatment with pamidronate?

• Fever

• Loss of appetite

What are the less common (occur in 10% to 29% of patients) side effects of treatment with pamidronate?

• High blood pressure

• Fatigue

• Headache

• Abnormal electrolyte levels as determined by blood tests, such as low levels of phosphate, potassium or magnesium

• Nausea and vomiting

• Pain, swelling or redness at site of infusion

• Bone pain

• Muscle pain

• Joint pain

• Constipation

• Diarrhea

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

• Pay careful attention to the physician’s instructions and inform the physician of any side effects.

• Maintain adequate rest and nutrition.

• Wear sunscreen and protective clothing and try to minimize sun exposure.

• Drink plenty of fluids. (Patients should ask their physician about the amount of liquid to consume during a day.)

• Eat small meals frequently to help alleviate nausea.

Are there any special precautions patients should be aware of before starting treatment?

• Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. This drug may cause birth defects. It is important to use some kind of birth control while undergoing treatment. Also, patients may want to talk to their physician if they are considering having children in the future, since some drugs may cause fertility problems.

• It is important that patients inform their physician of any pre-existing conditions (chicken pox, heart disease, kidney disease, liver disease, lung disease, etc.) as they may worsen with this drug.

• Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.

• Patients should check with their physician before starting any new drug or nutritional supplement.

• Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

• Signs of hypercalcemia - muscle twitching, frequent urination, loss of appetite, nausea or vomiting, constipation, weakness or fatigue, muscle, confusion and coma

• Swelling of ankles and feet

• Sudden weight gain

• Persistent or severe headache or other pain

• Seizures

• Acute bone pain

• Blurred vision or irritated eyes

• Allergic reaction (skin rash, hives, itching, difficulty breathing, tightness of chest or throat)

• Change in heart rate or rhythm

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some of clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug.By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Important Limitations of Use

The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.

As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.

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Tags: Miscellaneous, P